System, method, and apparatus for visualizing cardiac timing information using animations

ABSTRACT

An animated electrophysiology map is generated from a plurality of data points, each including measured electrophysiology information, location information, and timing information. The electrophysiology and location information can be used to generate the electrophysiology map, such as a local activation time, peak-to-peak voltage, or fractionation map. Animated timing markers can be superimposed upon the electrophysiology map using the electrophysiology, location, and timing information. For example a series of frames can be displayed sequentially, each including a static image of the electrophysiology map at a point in time and timing markers corresponding to the state or position of an activation wavefront at the point in time superimposed thereon. The visibility or opacity of the timing markers can be adjusted from frame to frame, dependent upon a distance between the timing marker and the activation wavefront, to give the illusion that the timing markers are moving along the electrophysiology map.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. provisional application No.62/100,710, filed 7 Jan. 2015, which is hereby incorporated by referenceas though fully set forth herein.

BACKGROUND

The present disclosure relates generally to electrophysiologicalvisualization and mapping. More specifically, the present disclosurerelates to a system, method, and apparatus for generating animatedelectrophysiological maps for visualizing cardiac timing information onthe surface of a model.

Anatomical mapping, such as cardiac electrophysiological mapping, isused in numerous diagnostic and therapeutic procedures. In certainprocedures, for example, various components associated with adepolarization wave are detected from electrogram signals obtained froma diagnostic catheter, and are used to generate a map, such as a localactivation time (“LAT”) map, a peak-to-peak (“PP”) voltage map, or acomplex fractionated electrogram (“CFE”) map. Typically, such maps arestatic maps that employ colors and/or shading to represent parameterssuch as activation time, voltage, and degree of fractionation.

In some cases, it may be difficult to understand the directionality ofcardiac activation wavefronts as they travel across the heart. Preciseknowledge of this information is often important, however, to accuratelydiscern patterns associated with certain cardiac arrhythmias. In someinstances, such information may facilitate the detection of more complexrhythms that would otherwise be difficult to discern from moretraditional, static maps.

BRIEF SUMMARY

Disclosed herein is a method of generating an animated electrophysiologymap including the steps of: receiving a plurality of data points, eachdata point including measured electrophysiology information, locationinformation, and timing information; generating an electrophysiology mapusing the electrophysiology information and location information of theplurality of data points; and superimposing an animation of a pluralityof timing markers upon the electrophysiology map using theelectrophysiology information, the location information, and the timinginformation for the plurality of data points.

According to aspects of the disclosure, the step of superimposing ananimation of a plurality of timing markers upon the electrophysiologymap includes generating a series of frames, each frame of the series offrames including: a static image of the electrophysiology map at a pointin time; and one or more timing markers superimposed upon the staticimage of the electrophysiology map, the one or more timing markerscorresponding to an activation wavefront at the point in time. Theframes can be displayed in chronological sequence.

It is contemplated that a visibility, such as an opacity, of a timingmarker of the one or more timing markers is related to a distancebetween a position of the activation wavefront on the electrophysiologymap at the point in time and a position of the timing marker on theelectrophysiology map. For example, the closer the timing marker is tothe position of the activation wavefront, the more visible (e.g., themore opaque) the timing marker can be.

According to other aspects of the disclosure, the step of superimposingan animation of a plurality of timing markers upon the electrophysiologymap includes depicting an activation wavefront moving across theelectrophysiology map over time.

In still further aspects of the disclosure, the step of superimposing ananimation of a plurality of timing markers upon the electrophysiologymap includes: increasing a visibility of a first timing marker from aminimum visibility to a maximum visibility; decreasing the visibility ofthe first timing marker from the maximum visibility to the minimumvisibility; increasing a visibility of a second timing marker from theminimum visibility to the maximum visibility; and decreasing thevisibility of the second timing marker from the maximum visibility tothe minimum visibility. Optionally, the steps of decreasing thevisibility of the first timing marker and increasing the visibility ofthe second timing marker can occur concurrently (e.g., the first timingmarker can be fading out as the second timing marker is fading in).Indeed, a first time period over which at least one of the step ofincreasing a visibility of the first timing marker and the step ofincreasing a visibility of a second timing marker occurs can be shorterthan a second time period over which at least one of the step ofdecreasing the visibility of the first timing marker and the step ofdecreasing the visibility of the second timing marker occurs.

Various electrophysiology maps, including local activation timing maps,activation timing propagation maps, peak-to-peak voltage maps, andfractionation maps are contemplated. Likewise, the plurality of timingmarkers can include a plurality of maximum voltage over time markers.

Also disclosed herein is a method of generating an animated map of acardiac activation wavefront, including: receiving a plurality of datapoints, wherein each data point of the plurality of data points includeslocation information and activation timing information; displaying amodel of a portion of a cardiac surface; and sequentially displaying aplurality of time markers corresponding to the plurality of data pointsover a playback time period, wherein, for each time marker of theplurality of time markers: a time marker display location is determinedby the location information for a respective data point of the pluralityof data points, and a time marker display sequence is determined by theactivation timing information for the respective data point of theplurality of data points. The model of a portion of the cardiac surfacecan include an electrophysiology map of the portion of the cardiacsurface.

In further embodiments, for each time marker of the plurality of timemarkers, the time marker has a maximum visibility time during theplayback time period determined by the activation timing information forthe respective data point of the plurality of data points, the timemarker fades in starting at a fade in initiation time preceding themaximum visibility time, and the time marker fades out starting at themaximum visibility time and ending at a fade out completion timefollowing the maximum visibility time. The fade in initiation time canprecede the maximum visibility time by a first time period, and the fadeout completion time can follow the maximum visibility time by a secondtime period longer than the first time period.

According to another embodiment disclosed herein, a system forsuperimposing an animated timing sequence onto an electrophysiologicalmap includes: computer configured to: receive a plurality ofthree-dimensional data points each including timing activationinformation; generate an electrophysiological map on a display screenbased on the plurality of three-dimensional data points; initiate aplayback animation to generate a sequence of cardiac timing activationframes over time, each frame including an active timing marker; andsuperimpose, for each frame, the active timing marker onto theelectrophysiological map; wherein the computer is configured to adjustan opacity of the active timing marker on the display screen based on acurrent time of the playback animation. The computer can also beconfigured to adjust the opacity of the active timing marker to fade into a maximum opacity and to fade out from the maximum opacity based on acurrent time of the playback animation.

The foregoing and other aspects, features, details, utilities, andadvantages of the present invention will be apparent from reading thefollowing description and claims, and from reviewing the accompanyingdrawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic diagram of an exemplary electroanatomical mappingsystem, such as may be used in an electrophysiology study.

FIG. 2 depicts an exemplary catheter that can be used in anelectrophysiology study.

FIGS. 3A-3F are several screen shots of a graphical user interface usedfor generating an animated electrophysiology map in accordance with anexemplary embodiment of the present disclosure.

FIGS. 4A-4F are several screen shots of a graphical user interface usedfor generating an animated map by superimposing timing markers onto apeak-to-peak voltage map.

FIGS. 5A-5F are several screen shots of a graphical user interface usedfor generating an animated map by superimposing timing markers onto afractionation map.

FIG. 6 is a graph showing the change in opacity state of a timing markerover time.

FIG. 7 is a flow diagram depicting several exemplary steps tiergenerating an animated map in accordance with an exemplary embodiment ofthe present disclosure.

DETAILED DESCRIPTION

The present disclosure provides systems, methods, and apparatus for thecreation of electrophysiology maps (e.g., electrocardiographic maps).For purposes of illustration, several exemplary embodiments will bedescribed in detail herein in the context of cardiac electrophysiology.It is contemplated, however, that the systems, methods, and apparatuses,described herein can be utilized in other contexts.

FIG. 1 shows a schematic diagram of an exemplary system 8 for conductingcardiac electrophysiology studies by navigating a cardiac catheter andmeasuring electrical activity occurring in a heart 10 of a patient 11and three-dimensionally mapping the electrical activity and/orinformation related to or representative of the electrical activity someasured. System 8 can be used, for example, to create an anatomicalmodel of the patient's heart 10 using one or more electrodes. System 8can also be used to measure electrophysiology data at a plurality ofpoints along a cardiac surface and store the measured data inassociation with location information for each measurement point atwhich the electrophysiology data was measured, for example to create adiagnostic data map of the patient's heart 10. In some embodiments, andas discussed further herein, the system 8 can be used to generateanimated electrophysiology maps that can be used to better visualizecardiac timing information over a period of time, allowing a clinicianto better visualize and assess conduction velocity patterns across thesurface of the heart 10. In some embodiments, for example, animatedcardiac timing information can be superimposed onto another map such asa local activation timing (LAT) propagation map, a peak-to-peak voltagemap, and/or a fractionated electrogram map to aid the clinician indetermining the source of an arrhythmia.

As one of ordinary skill in the art will recognize, and as will befurther described below, system 8 determines the location, and in someaspects the orientation, of objects, typically within athree-dimensional space, and expresses those locations as positioninformation determined relative to at least one reference.

For simplicity of illustration, the patient 11 is depicted schematicallyas an oval. In the embodiment shown in FIG. 1, three sets of surfaceelectrodes (e.g., patch electrodes) are shown applied to a surface ofthe patient 11, defining three generally orthogonal axes, referred toherein as an x-axis, a y-axis, and a z-axis. In other embodiments theelectrodes could be positioned in other arrangements, for examplemultiple electrodes on a particular body surface. As a furtheralternative, the electrodes do not need to be on the body surface, butcould be positioned internally to the body.

In FIG. 1, the x-axis surface electrodes 12, 14 are applied to thepatient along a first axis, such as on the lateral sides of the thoraxregion of the patient (e.g., applied to the patient's skin underneatheach arm) and may be referred to as the Left and Right electrodes. They-axis electrodes 18, 19 are applied to the patient along a second axisgenerally orthogonal to the x-axis, such as along the inner thigh andneck regions of the patient, and may be referred to as the Left Leg andNeck electrodes. The z-axis electrodes 16, 22 are applied along a thirdaxis generally orthogonal to both the x-axis and the y-axis, such asalong the sternum and spine of the patient in the thorax region, and maybe referred to as the Chest and Back electrodes. The heart 10 liesbetween these pairs of surface electrodes 12/14, 18/19, and 16/22.

An additional surface reference electrode (e.g., a “belly patch”) 21provides a reference and/or ground electrode for the system 8. The bellypatch electrode 21 may be an alternative to a fixed intra-cardiacelectrode 31, described in further detail below. It should also beappreciated that, in addition, the patient 11 may have most or all ofthe conventional electrocardiogram (“ECG” or “EKG”) system leads inplace. In certain embodiments, for example, a standard set of 12 ECGleads may be utilized for sensing electrocardiograms on the patient'sheart 10. This ECG information is available to the system 8 (e.g., itcan be provided as input to computer system 20). Insofar as ECG leadsare well understood, and for the sake of clarity in the figures, theleads and their connections to computer 20 are not illustrated in FIG.1.

A representative catheter 13 having at least one electrode 17 (e.g., adistal electrode) is also shown. This representative catheter electrode17 is referred to as the “roving electrode,” “moving electrode,” or“measurement electrode” throughout the specification. Typically,multiple electrodes on catheter 13, or on multiple such catheters, willbe used. In one embodiment, for example, localization system 8 maycomprise sixty-four electrodes on twelve catheters disposed within theheart and/or vasculature of the patient. Of course, this embodiment ismerely exemplary, and any number of electrodes and catheters may be usedwithin the scope of the present invention. Likewise, it should beunderstood that catheter 13 (or multiple such catheters) are typicallyintroduced into the heart and/or vasculature of the patient via one ormore introducers (not shown in FIG. 1, but readily understood by theordinarily skilled artisan).

For purposes of this disclosure, a segment of an exemplary catheter 13is shown in FIG. 2. Catheter 13 extends into the left ventricle 50 ofthe patient's heart 10 through an introducer 35, the distal-most segmentof which is shown in FIG. 2. The construction of introducers, such asintroducer 35, are well known and will be familiar to those of ordinaryskill in the art, and need not be further described herein. Of course,catheter 13 can also be introduced into the heart 10 without the use ofintroducer 35.

Catheter 13 includes electrode 17 on its distal tip, as well as aplurality of additional measurement electrodes 52, 54, 56 spaced alongits length in the illustrated embodiment. Typically, the spacing betweenadjacent electrodes will be known, though it should be understood thatthe electrodes may not be evenly spaced along catheter 13 or of equalsize to each other. Since each of these electrodes 17, 52, 54, 56 lieswithin the patient, location data may be collected simultaneously foreach of the electrodes by localization system 8.

Returning now to FIG. 1, an optional fixed reference electrode 31 (e.g.,attached to a wall of the heart 10) is shown on a second catheter 29.For calibration purposes, this electrode 31 may be stationary (e.g.,attached to or near the wall of the heart) or disposed in a fixedspatial relationship with the roving electrodes (e.g., electrodes 17,52, 54, 56), and thus may be referred to as a “navigational reference”or “local reference.” The fixed reference electrode 31 may be used inaddition or alternatively to the surface reference electrode 21described above. In many instances, a coronary sinus electrode or otherfixed electrode in the heart 10 can be used as a reference for measuringvoltages and displacements; that is, as described below, fixed referenceelectrode 31 may define the origin of a coordinate system.

Each surface electrode is coupled to a multiplex switch 24, and thepairs of surface electrodes are selected by software running on acomputer 20, which couples the surface electrodes to a signal generator25. Alternately, switch 24 may be eliminated and multiple (e.g., three)instances of signal generator 25 may be provided, one for eachmeasurement axis (that is, each surface electrode pairing).

The computer 20, for example, may comprise a conventionalgeneral-purpose computer, a special-purpose computer, a distributedcomputer, or any other type of computer. The computer 20 may compriseone or more processors 28, such as a single central processing unit(CPU), or a plurality of processing units, commonly referred to as aparallel processing environment, which may execute instructions topractice the various aspects of the present invention described herein.

Generally, three nominally orthogonal electric fields are generated by aseries of driven and sensed electric dipoles (e.g., surface electrodepairs 12/14, 18/19, and 16/22) in order to realize catheter navigationin a biological conductor. Alternatively, these orthogonal fields can bedecomposed and any pairs of surface electrodes can be driven as dipolesto provide effective electrode triangulation. Likewise, the electrodes12, 14, 18, 19, 16, and 22 (or any number of electrodes) could bepositioned in any other effective arrangement for driving a current toor sensing a current from an electrode in the heart. For example,multiple electrodes could be placed on the back, sides, and/or belly ofpatient 11. Additionally, such non-orthogonal methodologies add to theflexibility of the system. For any desired axis, the potentials measuredacross the roving electrodes resulting from a predetermined set of drive(source-sink) configurations may be combined algebraically to yield thesame effective potential as would be obtained by simply driving auniform current along the orthogonal axes.

Thus, any two of the surface electrodes 12, 14, 16, 18, 19, 22 may beselected as a dipole source and drain with respect to a groundreference, such as belly patch 21, while the unexcited electrodesmeasure voltage with respect to the ground reference. The rovingelectrodes 17, 52, 54, 56 placed in the heart 10 are exposed to thefield from a current pulse and are measured with respect to ground, suchas belly patch 21. In practice the catheters within the heart 10 maycontain more or fewer electrodes than the four shown, and each electrodepotential may be measured. As previously noted, at least one electrodemay be fixed to the interior surface of the heart to form a fixedreference electrode 31, which is also measured with respect to ground,such as belly patch 21, and which may be defined as the origin of thecoordinate system relative to which localization system 8 measurespositions. Data sets from each of the surface electrodes, the internalelectrodes, and the virtual electrodes may all be used to determine thelocation of the roving electrodes 17, 52, 54, 56 within heart 10.

The measured voltages may be used to determine the location inthree-dimensional space of the electrodes inside the heart, such asroving electrodes 17, 52, 54, 56, relative to a reference location, suchas reference electrode 31. That is, the voltages measured at referenceelectrode 31 may be used to define the origin of a coordinate system,while the voltages measured at roving electrodes 17, 52, 54, 56 may beused to express the location of roving electrodes 17, 52, 54, 56relative to the origin. In some embodiments, the coordinate system is athree-dimensional (x, y, z) Cartesian coordinate system, although othercoordinate systems, such as polar, spherical, and cylindrical coordinatesystems, are contemplated.

As should be clear from the foregoing discussion, the data used todetermine the location of the electrode(s) within the heart is measuredwhile the surface electrode pairs impress an electric field on theheart. The electrode data may also be used to create a respirationcompensation value used to improve the raw location data for theelectrode locations as described in U.S. Pat. No. 7,263,397, which ishereby incorporated herein by reference in its entirety. The electrodedata may also be used to compensate for changes in the impedance of thebody of the patient as described, for example, in U.S. Pat. No.7,885,707, which is also incorporated herein by reference in itsentirety.

Therefore, in one representative embodiment, the system 8 first selectsa set of surface electrodes and then drives them with current pulses.While the current pulses are being delivered, electrical activity, suchas the voltages measured with at least one of the remaining surfaceelectrodes and in vivo electrodes, is measured and stored. Compensationfor artifacts, such as respiration and/or impedance shifting, may beperformed as indicated above.

In some embodiments, the system 8 is the EnSite™ Velocity™ cardiacmapping system of St. Jude Medical, Inc., which generates electricalfields as described above, or another localization system that reliesupon electrical fields. Other localization systems, however, may be usedin connection with the present teachings, including for example, systemsthat utilize magnetic fields instead of or in addition to electricalfields for localization. Examples of such systems include, withoutlimitation, the CARTO navigation and location system of BiosenseWebster, Inc., the AURORA® system of Northern Digital Inc., Sterotaxis'NIOBE® Magnetic Navigation System, as well as MediGuide™ Technology fromSt. Jude Medical, Inc.

The localization and mapping systems described in the following patents(all of which are hereby incorporated by reference in their entireties)can also be used with the present invention: U.S. Pat. Nos. 6,990,370;6,978,168; 6,947,785; 6,939,309; 6,728,562; 6,640,119; 5,983,126; and5,697,377.

FIGS. 3A-3F are several screen shots of a graphical user interface (GUI)100 that can be used in conjunction with the system 8 of FIG. 1 forgenerating an animated electrophysiology map in accordance with anexemplary embodiment of the present disclosure. The screen shots inFIGS. 3A-3F may represent, for example, several exemplary viewsgenerated by computer 20 that, when displayed as a sequence over aperiod of time (e.g., one or more cardiac cycles), depict an animationshowing the timing of cardiac activations across the surface of a heart10.

As can be seen in a first view in FIG. 3A, the GUI 100 includes a seriesof controls 102 that can be used for generating an electrophysiologicalmap 104 on a display screen 106. In certain procedures, for example, theGUI 100 can be used for displaying a local activation timing (LAT)propagation map 104 on the model surface, as shown. The use of LAT maps108 is generally known in electrophysiology procedures, and is thus notdescribed in detail herein for sake of brevity. As can be seen in FIG.3A, the LAT map 104 uses different colors across the surface of themodel to depict the timing of cardiac activations, with relatively earlyactivation times represented as white, red, or orange colors andrelatively late activation times represented as blue, indigo, and violetcolors on the map 104.

As can be further seen in FIG. 3A, the GUI 100 is further configured todisplay a sequence of timing markers 108 that can be used either aloneor in conjunction with the LAT map 104 to provide the clinician with abetter understanding of the timing sequence of cardiac activations. Insome embodiments, the timing markers 108 may each comprise a large dot,point, or other suitable graphical representation that can besuperimposed onto the display screen 106 over the LAT map 104, as shown.Each of the timing markers 108 may represent, for example, a voltagemeasured at a particular three dimensional location on the heart using acatheter such as catheter 13 described herein in conjunction with FIGS.1-2. In some embodiments, for example, the timing markers 108 representa maximum voltage as measured by one or multiple of the catheterelectrodes 17, 52, 54, 56 during a single cardiac cycle, or acrossmultiple cardiac cycles. As with the measurements used in generating theLAT map 104, the system 8 tracks the location of each discrete timingmarker 108 and superimposes the marker 108 over the map 104. To ensurethat the timing markers 104 visually stand-out from the colors used bythe LAT map 104, the system 8 may assign a different color (e.g., neongreen) to each timing marker 108.

FIGS. 3B-3F depict several additional views or frames showing thevisualization of an activation sequence animation using the timingmarkers 108. As can be further understood with respect to FIGS. 3B-3F,the system 8 is configured to display an animation of an activationsequence by adjusting the opacity of each timing marker 108 over aplayback time. During the playback of an animation, the timing markers108 representative of the activation wavefront at a particular time areselectively displayed on the screen 106 whereas timing values that arenot at or near the current playback time are removed from the screen106. By comparison of FIG. 3B-3C, for example, which may represent atime difference in the cardiac cycle of approximately 20 ms, thelocation of the timing markers 108 can be seen to have shifted from afirst location on the map 104 to a second location thereon. When viewedas a temporal sequence, the timing markers 108 appear to move across thesurface of the map 104, providing an illusion that the markers 108 arein motion; a phenomenon similar to that of objects contained inindividual frames of a motion picture.

This process of selectively displaying and removing the timing markers108 in this fashion allows the clinician to better discern patternsand/or directionality that would otherwise not be apparent byinterpreting between color bands on a static map such as a traditionalLAT map. For instance, unlike a traditional LAT map, the ability toplayback an animation of the timing markers 108 provides the clinicianwith an improved understanding of the directionality (and in some casesalso the source) of the wavefront. In some instances, this mayfacilitate the detection of more complex rhythms that would otherwise bedifficult to discern from a static map.

In some embodiments, the system 8 is configured to adjust a level ofopacity of each of the timing markers 108 depending on the timing of themeasurement relative to the current playback time. In certainembodiments, and as further shown in FIG. 6, the system 8 can beconfigured to adjust the opacity of the timing marker 108 between afirst, invisible state to a second, bright state based on the LAT timingvalue associated with that marker 108. The opacity state of each of thetiming markers 108 over time (t) can be represented graphically as acurve 110, beginning at time t=0 and ending at a later point t, whichmay represent the end of a full cardiac cycle or multiple such cycles.From an initial point 112 on the curve 110 to point 114 thereon, whenthe current playback time (t) is at or near the LAT time associated withthe mapping point, the system 8 can be configured to gradually increasethe opacity of the timing marker 108. At point 114 along the curve 110when the timing marker 108 coincides with the current playback time, themarker 108 is at its greatest opacity (that is, at its maximumvisibility). In similar fashion, the system 8 can be configured tofade-out or reduce the opacity of the timing marker 108 along the curve110 until at point 116, when the timing marker 108 disappears completelyfrom the screen (or is otherwise at its minimum visibility). In someembodiments, the fade-out time period (i.e., the time between thecurrent playback time to point 116) is greater than the fade-in period(i.e., the time period between point 112 and the current playback time114). For example, the fade-in period may comprise 6 ms whereas thefade-out period may comprise 44 ms.

At point 118 along the curve 110, the system 8 may then loop back totime t=0 and repeat the playback animation process one or moreadditional times, as desired. In use, the fading in and subsequentfading out of the timing markers 108 in this manner provides theclinician with a visual cue as to the activation pattern. This allowsthe clinician to better understand complex conduction patterns that maybe present on the map.

The process of adjusting the opacity of the timing markers 108temporally and in sequence can be seen graphically by a comparison ofFIGS. 3A-3F. Starting at an initial state in FIG. 3A which may representthe beginning of the cardiac cycle, for example, the system 8 maydisplay timing markers 108 a on the map. At a second time period, asshown in FIG. 3B by the difference in opacity depicted on the screen,the system 8 is configured to fade-out the timing markers 108 a andconversely fade-in timing markers 108 b. This process may be repeatedone or more times (i.e., as shown in FIGS. 3C-3F) to generate additionalframe sequences on the map 104. The generation of a sequence of framesin this manner provides a visual effect that the timing markers 110 aretravelling across the map when, in fact, the different frames in thesequence are actually static.

From the example animation sequence in FIGS. 3A-3F, the clinician maydeduce that the cardiac activation follows a path around a line ofblock. Activation patterns visualized in this manner can then beanalyzed to determine the mechanism for an aberrant conduction and treatthe condition, if desired. An example system and method for diagnosingarrhythmias and directing catheter therapies is disclosed in U.S. Pat.No. 9,186,081, the contents of which are incorporated herein byreference in their entirety for all purposes.

The system 8 can be configured to superimpose the timing markers 108onto other electrophysiological maps to further facilitate the diagnosisand treatment of various arrhythmias. In another animation sequenceshown in FIGS. 4A-4F, for example, the system 8 is configured tosuperimpose timing markers 108 onto a peak-to-peak voltage map 120. Inanother exemplary animation sequence shown in FIGS. 5A-5F, the system 8is configured to superimpose the timing markers 108 onto a fractionationmap 122 which shows the level or degree of fractionation in electrogramssensed at various locations on the surface of the heart. The system 8can be configured to superimpose timing markers 108 onto other types ofmaps and/or onto multiple, composite maps types. In one embodiment, forexample, the system 8 can be used to generate timing markers onto a mapcontaining both an LAT map as well as a fractionation map. Othervariations are also possible.

FIG. 7 is a flow diagram showing several steps of an exemplary method124 that can be used for superimposing an animated sequence of timingmarkers onto an electrophysiological map. The method 124 may begingenerally at block 126, in which a mapping system and catheter are usedto measure three dimensional data points on a surface of a heart,wherein the data points include associated activation timing data. Block126 may represent, for example, the process of using the exemplarysystem 8 and catheter 13 described above with respect to FIGS. 1-2 togather activation timing and voltage information at different locationson a model of the heart.

At block 128, a playback animation can be initiated (e.g., by the uservia the selection of an icon button on the GUI) to generate a sequenceof activation frames each containing an associated timing point for eachthree dimensional data point collected by the system 8. During eachplayback animation, the system 8 is configured to selectively displayonly those timing markers 108 that are associated with a time at or nearthe current playback time. As the time associated with the data pointbecomes more aligned with the current playback time, the systemincreases the opacity of the marker, causing the marker to be displayedinitially as a shadow or silhouette on the display screen, as indicatedgenerally at block 130. When the measured activation time is alignedwith the current playback time, the timing marker is displayed at itsbrightest (block 132), providing the user with an indication of thelocation of the activation wavefront. Afterwards, the system 8 thendecreases the level of opacity until that particular time marker is nolonger visible on the screen, as indicated at block 134. The process isthen repeated one or more times to create an animated sequence of framesthat is superimposed over the map, as indicated at decision block 136.The clinician may then determine one or more candidate sites forpotential treatment, as indicated at block 138.

All directional references (e.g., upper, lower, upward, downward, left,right, leftward, rightward, top, bottom, above, below, vertical,horizontal, clockwise, and counterclockwise) are only used foridentification purposes to aid the reader's understanding of the presentinvention, and do not create limitations, particularly as to theposition, orientation, or use of the invention. Joinder references(e.g., attached, coupled, connected, and the like) are to be construedbroadly and may include intermediate members between a connection ofelements and relative movement between elements. As such, joinderreferences do not necessarily infer that two elements are directlyconnected and in fixed relation to each other.

It is intended that all matter contained in the above description orshown in the accompanying drawings shall be interpreted as illustrativeonly and not limiting. Changes in detail or structure may be madewithout departing from the spirit of the invention as defined in theappended claims.

What is claimed is:
 1. A method of generating an animatedelectrophysiology map, the method comprising: receiving a plurality ofdata points, each data point comprising measured electrophysiologyinformation, location information, and timing information; generating anelectrophysiology map using the electrophysiology information andlocation information of the plurality of data points; and superimposingan animation of a plurality of timing markers upon the electrophysiologymap using the electrophysiology information, the location information,and the timing information for the plurality of data points, whereinsuperimposing an animation of a plurality of timing markers upon theelectrophysiology map comprises: generating a series of frames, eachframe of the series of frames comprising: a static image of theelectrophysiology map at a point in time; and one or more timing markerssuperimposed upon the static image of the electrophysiology map, whereinpositions of the one or more timing markers upon the static image of theelectrophysiology map correspond to a position of an activationwavefront on the electrophysiology map at the point in time, wherein theone or more timing markers are visible upon the static image of theelectrophysiology map at the point in time only within a preset distanceof the position of the activation wavefront on the electrophysiology mapat the point in time, and wherein a visibility of a timing marker of theone or more timing markers is related to a distance between the positionof the activation wavefront on the electrophysiology map at the point intime and a position of the timing marker on the electrophysiology map;and displaying the series of frames in chronological sequence.
 2. Themethod according to claim 1, wherein an opacity of the timing marker isrelated to the distance between the position of the activation wavefronton the electrophysiology map at the point in time and the position ofthe timing marker on the electrophysiology map.
 3. The method accordingto claim 1, wherein superimposing an animation of a plurality of timingmarkers upon the electrophysiology map comprises depicting an activationwavefront moving across the electrophysiology map over time.
 4. Themethod according to claim 1, wherein superimposing an animation of aplurality of timing markers upon the electrophysiology map comprises:increasing a visibility of a first timing marker from a minimumvisibility to a maximum visibility; decreasing the visibility of thefirst timing marker from the maximum visibility to the minimumvisibility; increasing a visibility of a second timing marker from theminimum visibility to the maximum visibility; and decreasing thevisibility of the second timing marker from the maximum visibility tothe minimum visibility.
 5. The method according to claim 4, wherein thesteps of decreasing the visibility of the first timing marker andincreasing the visibility of the second timing marker occurconcurrently.
 6. The method according to claim 4, wherein at least oneof the step of increasing a visibility of a first timing marker and thestep of increasing a visibility of a second timing marker occurs over afirst time period.
 7. The method according to claim 6, wherein at leastone of the step of decreasing the visibility of the first timing markerand the step of decreasing the visibility of the second timing markeroccurs over a second time period longer than the first time period. 8.The method according to claim 1, wherein the electrophysiology mapcomprises a local activation timing map.
 9. The method according toclaim 1, wherein the electrophysiology map comprises a peak-to-peakvoltage map.
 10. The method according to claim 1, wherein theelectrophysiology map comprises a fractionation map.
 11. The methodaccording to claim 1, wherein the plurality of timing markers comprise aplurality of maximum voltage over time markers.